Lead Awareness Training for

Childcare Providers

June 2008

Purpose of Today’s Training 9 Provide general background on lead hazards and

related health effects 9 Basic knowledge and signs of lead hazards 9 Share this information with parents and other

childcare providers, as well as your friends and family

9 Encourage parents to have their children tested for lead poisoning

9 Help prevent high levels of lead in the blood of children you care for

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This child may be eating poison.

This poison can damage her brain.

She may have learning and behavior problems for the rest of her life.

This poison is lead.

WHAT IS LEAD? 9 Lead is a heavy, bluish/gray, soft,

malleable metal

9 Known to be a hazard since ancient times

9 Negative effects of lead were recognized by Ben Franklin in 1786

9 Lead use and occupational exposures accelerated during the 1800’s

9 First case of lead paint poisoning was diagnosed in Australia in 1895

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LEAD IN PAINT

9 Pigmentation

9 Durability

9 Corrosion resistance

REASONS LEAD WAS ADDED TO PAINT:

Lead Poisoning Has Multiple Sources 9 In San Diego County, 28% from

paint, soil, and dust

9 Other common sources include: pottery used for food, housewares, home remedies food, imported candy, water, toys, jewelry,decorative goods, hobbies, andoccupational hazards

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Major Source of Lead Exposure: Lead-Based Household Paint

Paint sold before 1978 may contain lead 9 Normal wear and tear of paint produces lead dust,

the most common source of lead poisoning

9 Deteriorating paint may produce dust and flakes

9 Disturbing intact lead-based paint during remodeling, renovation, and maintenance can create a lead hazard

66% of San Diego housing was built before 1978

Childhood Blood Lead Poisoning in City of San Diego

CDC definition of lead poisoned child is >10 ug/dL (Elevated Blood Lead - EBL)

0

20

40

60

80

100

120

EBLs in 2006

# of

chi

ldre

n

> 14.5 ug/dL > 9.5 ug/dL

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Childhood Blood Lead Poisoning in City of San Diego

CDC definition of lead poisoned child is >10 ug/dL (Elevated Blood Lead - EBL)

0 1000 2000 3000 4000 5000 6000 7000 8000 9000

EBLs in 2006 28% Related to Env. Sources

# of

chi

ldre

n

> 14.5 ug/dL > 9.5 ug/dL > 4.5 ug/dL Estimated EBLs*

* Estimate based on only 11% of children are given blood lead test in 2006

Main Ways That Lead Gets Into the Body

9 Swallowing lead-paint dust or flakes, mainly through normal hand-to-mouth activity

9 Breathing in lead dust

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At Greatest Risk: Very Young Children

Very young children, who crawl on the floor and put their hands and toys in their mouths, are at highest risk of exposure and are most susceptible to damage.

Children should be tested at 1 and 2 years of age and as recommended by the child’s physician.

Even very small amounts of lead are dangerous.

Symptoms of Lead Poisoning in Children USUALLY THERE ARE

NO SYMPTOMS 9 Fatigue 9 Irritability 9 Headache 9 Constipation 9 Stomachache 9 Cramps 9 Vomiting 9 Weight loss

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Lead’s Effects on Unborn Children 9 Lead from the mother’s blood

can pass to the unborn child 9 Lead poisoning in unborn

children can cause

� Learning difficulties � Behavioral problems � Brain and nerve damage � Stillbirth and miscarriage � Premature birth � Low birth weight

Lead’s Effects on Babies and Young Children

9 Can damage the brain and other parts of the nervous system

9 Can cause behavior and learning problems

9 Can reduce muscle and bone growth

9 Can damage hearing 9 Can cause death

Even children who seem healthy may have high

levels of lead

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Highest decrease in child’s IQ occurs when blood lead level is less than 10 ug/dL – on average, 7.3

New England Journal of Medicine; April 17, 2003

Symptoms of Lead Poisoning in Adults 9 Fatigue 9 Constipation or 9 Irritability diarrhea 9 Anxiety 9 Cramps 9 Depression 9 Vomiting or nausea

9 Weight loss9 Headache 9 Sleeplessness 9 Muscle or joint

pain9 Tremors 9 Weakness in arms,9 Metallic taste in mouth

legs, or wrists 9 Skin paleness,

9 Loss of sex drive especially of the face 9 Stomachache

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Lead’s Effects on Adults

99 High bloodHigh blood pressurepressure

99 DigestiveDigestive disordersdisorders

99 Nervous syNervous systemstem problemsproblems

99 DifficultDifficultyy ww iithth 99 Reproductive problemsReproductive problems memorymemory andandfor men and womenfor men and women concentrationconcentration

LEAD-BASED PAINT HAZARD

A lead-based paint hazard is any condition that causes exposure to lead from:

9 Lead-contaminated dust

9 Lead-contaminated soil

9 Paint that is deteriorated or present on accessible, friction, or impact surfaces

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LEAD-SAFE WORK PRACTICES (LSWP) If home built prior to 1979, any disturbance of paint must be done using LSWP in accordance with San Diego Municipal Code 54.1005-1006 & Appendix A

9 Paint on home built prior to 1979 is presumed to contain lead

9 Disturbance of paint with lead concentrations at or above 1000 ppm or 0.5 mg/cm2 must use LSWP

LEAD DUST HAZARD

9 Floor is 40 µg/ft2

9 Interior window sill is 250 µg/ft2

9 Exterior window/porch/ground is 400 µg/ft2

9 Soil for children’s play area is 400 ppm

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Identify Deteriorated Paint To identify deteriorated paint, you will need to answer this question:

Is the paint peeling, chipped, chalking or cracking?

If the answer to this question is yes, then the paint should be considered deteriorated.

Identify Deteriorated Paint Is There Anything Else You Should Look For?

When performing a visual assessment, you should look for:

9 Paint chips or dust from painting that were not cleaned up.

9 Paint residue on the floors .

9 Evidence of paint chips in soil near foundation on exterior.

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Identify Deteriorated Paint

These photos show evidence of substrate damage: 9 The window sill has extensive moisture damage.

9 The stair tread shows wear, tear and deterioration.

Distressed Furniture

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Exterior siding, window components Deteriorated Stair Rails

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Window casing - Extreme picking Teeth Marks on Walls

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Door casing - Impact damage

Note: This may look like an insignificant amount of deterioration, but this can still be dangerous to children and is still considered a hazard.

Exterior window casing

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Paint Chips on Ground Concrete Floor

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What Caregivers Can Do 9 Make sure your facility does not expose

children to lead

9 Avoid damaging painted surfaces

9 Inspect regularly for water leaks and paint damage. The source of the water leak, must be fixed before the paint hazard can be fixed.

9 CLEAN, CLEAN, CLEANWet-dust and clean floors and window sills regularly with water and detergent and paper towels

9 Become trained to fix lead hazards safelyyourself or have a friend or family member get trained to help you fix lead hazards.

What Caregivers Can Do 9 Teach parents about lead poisoning

9 Include information on lead poisoning and blood lead testing in your parent handbook and post information in your facility.

9 Encourage parents to have their children tested for lead poisoning – Children should be tested at 1 and 2 years of age and up to age 6 if never previously tested.

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What Caregivers Can Do 9 Teach children to keep non-food items out of their

mouths

9 Wash children’s hands and toys frequently because invisible lead dust may be present on them

9 Make sure toys are lead-free

What Caregivers Can Do

9 Feed children three regular meals and offer nutritious snacks between meals

9 Provide a well-balanced diet, low infat and high in iron, calcium, andVitamin C

9 Do NOT cook, serve, or store food in opened cans, in dishes that contain lead including water dispensers, or in leaded crystal.

A balance diet can help prevent the absorption of lead that is ingested

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San Diego Healthy Homes Project:

Eligibility criteria are: Low income tenants or owners, child under 6

living in or frequently visiting home

HUD Lead Hazard Control and Remediation Grants Eligibility criteria are:

Low income tenants or owners, child under 6 living in or frequently visiting home

Housing Rehabilitation Program

Offers 0% deferred loans for rehabilitation (some are forgivable)

Lead Safe Neighborhoods: 9 Serves as the primary liaison for connecting the

community to lead poisoning prevention resources

9 Through a grant with the San Diego Housing Commission, provides lead hazard removal to qualified residents.

9 Provides vouchers for free blood lead tests for children if they are not covered by any other program (resuming in July 2007).

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Lead Safe Neighborhoods: 9 Responds to lead hazard tips and complaints and works

with property owner or contractor to correct the problem.

9 Offers training on lead hazard awareness and lead safe work practices to contractors, property owners, childcare providers, parents/residents, tenants, and landlords.

9 Partnership with County CLPPP to perform environmental investigative services for EBL’s between 9.5-14.5 ug/dl.

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QUESTIONS? 858-694-7000

Lead-Safe@sandiego.gov

http://www.sandiego.gov/environmental-services/ep/leadsafe.shtml

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